Extracorporeal membrane oxygenation in adult patients with severe acute respiratory failure

Abstract

Patients with severe ARDS have a favourable outcome when treated with ECMO and when an ECMO retrieval team establishes the ECMO treatment at the referring hospital. SAPS-II, SOFA and Murray scores predicted the outcome.

Capabilities of a mobile extracorporeal membrane oxygenation service for severe respiratory failure delivered by intensive care specialists

“…There were also no major adverse events during transfer. We have also shown a high survival rate in patients who received ECMO -this exceeds those seen in an earlier randomised prospective trial and the CESAR trial [8,23], and is similar to that seen in more recent studies [18][19][20]. The use of newer veno-venous circuits, oxygenators and centrifugal pumps, and the improved biocompatibility and systemic anticoagulation requirements of heparin-bonded circuits, may go some way to explain these differences [24,25].…”

“…Despite the lack of surgical involvement common to other studies [18][19][20], there were no cannulation failures or significant ECMO complications. There were also no major adverse events during transfer.…”

“…On arrival back at our centre, the median (IQR [range]) Acute Physiology And Chronic Health Evaluation (APACHE) II and maximum Sequential Organ Failure Assessment (SOFA) scores were 17 (14-21 ) and 12 (9-15 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]), respectively. After transfer on ECMO, there were significant improvements in PaO 2 /F I O 2 ratio, ventilator F I O 2 , plateau mechanical ventilation pressure, pH and arterial PCO 2 (Table 3).…”

Long-Term Venovenous Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome

“…These findings were echoed in the Conventional Ventilation or ECMO for Severe Adults Respiratory Failure (CESAR) trial, which showed a 63% 6-month survival and a survival without disability benefit for ECMO (p ¼ 0.03) when compared with conventional therapy [5]. Similarly, among 124 patients treated in a 14-year span from 1997 to 2011 in Denmark, Lindskov and colleagues [6] reported a 71% (n ¼ 88 patients) rate of alive discharge. However, both the CESAR trial and the Danish study had relatively short ECMO support durations (9 days).…”

Outcome of Adult Respiratory Failure Patients Receiving Prolonged (≥14 Days) ECMO

“…The survival results of this study were also compared with other published reports and ELSO annual reports to compare short (0-13 days) and prolonged duration ECMO outcomes. 1,3,[21][22][23] Data are reported as mean AE standard deviation (SD) for normally distributed data or median and interquartile range (IQR) for nonnormal data. Continuous variables were compared between 2 groups using the independent Student t test, the Mann-Whitney U test, or 1-way ANOVA, as appropriate.…”